Historical Misdiagnosis of Recurrent Solitary Fibroma Tumor of the Prostate: A Cases Report and Current Evidence

Arch Esp Urol. 2023 Nov;76(9):711-717. doi: 10.56434/j.arch.esp.urol.20237609.87.

Abstract

Background: Solitary fibrous tumors (SFTs) manifest in various anatomical locations but are seldom encountered in the prostate. Despite their rare occurrence in this region, SFTs demonstrate a marked propensity for recurrence. This study elucidates a case of recurrent prostate SFT, previously misdiagnosed, and delineates the salient features and diagnostic criteria pertaining for SFTs.

Methods: Through a meticulous analysis of the patient's antecedent medical records and corroborative diagnostic evaluations, we hypothesized that the presenting pathology was indicative of a prostate SFT. In order to substantiate this supposition, we re-examined archival pathological specimens from the patient. The ensuing pathological assessment validated our conjecture. To address the recurrence, we conducted an open surgical procedure to excise the tumor. Subsequent postoperative pathological evaluations further corroborated the diagnosis of prostate SFT.

Results: Upon re-evaluation of the patient's earlier pathological specimens, we discerned that what had been previously classified as a "seminal vesicle tumor" was, in fact, a prostate SFT. During the surgical intervention, it was observed that the prostatic tumor had invaded the bladder, yet there was no seminal vesicle involvement. The tumor dimensions were approximately 7 × 5 × 4 cm, and the margin between the tumor and the surgical resection edge was less than 0.1 cm. The postoperative histological analysis confirmed the diagnosis of recurrent prostate SFT, substantiating our designation of the patient's condition as such. A year-long follow-up revealed no conspicuous signs of tumor recurrence.

Conclusions: Therapeutic intervention for prostate SFT is predominantly surgical. However, given the tumor's marked predisposition for recurrence, the specific mechanisms underlying its etiology and pathogenesis remain enigmatic. Hence, a comprehensive understanding of its pathogenic and recurrent characteristics, coupled with regular postoperative surveillance, is imperative for efficacious treatment and prevention of prostate SFT.

Keywords: immunohistochemistry; prostate; prostatectomy; solitary fibrous tumor (SFT).

Publication types

  • Case Reports

MeSH terms

  • Diagnostic Errors
  • Fibroma* / diagnosis
  • Fibroma* / surgery
  • Humans
  • Male
  • Prostate / pathology
  • Prostatic Neoplasms* / diagnosis
  • Prostatic Neoplasms* / pathology
  • Severe Fever with Thrombocytopenia Syndrome*
  • Solitary Fibrous Tumors* / pathology
  • Solitary Fibrous Tumors* / surgery